|
CHG DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 80305
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$2,169.73 |
| Rate for Payer: Aetna Commercial |
$16.88
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.88
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,169.73
|
| Rate for Payer: BCN Commercial |
$9.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$18.14
|
| Rate for Payer: Cofinity Commercial |
$16.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Nomi Health Commercial |
$15.12
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$17.64
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.65
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$12.65
|
| Rate for Payer: Priority Health SBD |
$12.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
CHG DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 80307
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$2,739.76 |
| Rate for Payer: Aetna Commercial |
$83.27
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.48
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,739.76
|
| Rate for Payer: BCN Commercial |
$62.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$83.27
|
| Rate for Payer: Cofinity Commercial |
$89.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Nomi Health Commercial |
$74.57
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$87.00
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.25
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$62.25
|
| Rate for Payer: Priority Health SBD |
$62.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
CHG DRUG TST PRSMV READ INSTRMNT ASSTD DIR OPT OBS
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 80306
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$1,676.30 |
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna Medicare |
$17.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.68
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCN Commercial |
$12.86
|
| Rate for Payer: BCN Medicare Advantage |
$17.14
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$22.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.00
|
| Rate for Payer: Nomi Health Commercial |
$20.57
|
| Rate for Payer: PACE SWMI |
$17.14
|
| Rate for Payer: PHP Commercial |
$24.00
|
| Rate for Payer: PHP Medicare Advantage |
$17.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.98
|
| Rate for Payer: Priority Health Medicare |
$17.14
|
| Rate for Payer: Priority Health Narrow Network |
$16.98
|
| Rate for Payer: Priority Health SBD |
$16.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.14
|
| Rate for Payer: UHC Medicare Advantage |
$17.14
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
CHG DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 77081
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$1,182.34 |
| Rate for Payer: Aetna Commercial |
$38.90
|
| Rate for Payer: Aetna Commercial |
$38.90
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.90
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$29.03
|
| Rate for Payer: BCBS MAPPO |
$29.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.34
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Medicare Advantage |
$29.03
|
| Rate for Payer: BCN Medicare Advantage |
$29.03
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$38.90
|
| Rate for Payer: Cofinity Commercial |
$41.80
|
| Rate for Payer: Cofinity Commercial |
$41.80
|
| Rate for Payer: Cofinity Commercial |
$38.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Nomi Health Commercial |
$34.84
|
| Rate for Payer: Nomi Health Commercial |
$34.84
|
| Rate for Payer: PACE SWMI |
$29.03
|
| Rate for Payer: PACE SWMI |
$29.03
|
| Rate for Payer: PHP Commercial |
$40.64
|
| Rate for Payer: PHP Commercial |
$40.64
|
| Rate for Payer: PHP Medicare Advantage |
$29.03
|
| Rate for Payer: PHP Medicare Advantage |
$29.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.75
|
| Rate for Payer: Priority Health Medicare |
$29.03
|
| Rate for Payer: Priority Health Medicare |
$29.03
|
| Rate for Payer: Priority Health Narrow Network |
$48.75
|
| Rate for Payer: Priority Health Narrow Network |
$48.75
|
| Rate for Payer: Priority Health SBD |
$14.37
|
| Rate for Payer: Priority Health SBD |
$14.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.03
|
| Rate for Payer: UHC Medicare Advantage |
$29.03
|
| Rate for Payer: UHC Medicare Advantage |
$29.03
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: UMR Bronson Commercial |
$74.06
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
CHG DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 77080
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$6,131.98 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCBS Trust/PPO |
$6,131.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,131.98
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Nomi Health Commercial |
$42.62
|
| Rate for Payer: Nomi Health Commercial |
$42.62
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PHP Commercial |
$49.73
|
| Rate for Payer: PHP Commercial |
$49.73
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.06
|
| Rate for Payer: Priority Health Medicare |
$35.52
|
| Rate for Payer: Priority Health Medicare |
$35.52
|
| Rate for Payer: Priority Health Narrow Network |
$60.06
|
| Rate for Payer: Priority Health Narrow Network |
$60.06
|
| Rate for Payer: Priority Health SBD |
$14.37
|
| Rate for Payer: Priority Health SBD |
$14.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: UMR Bronson Commercial |
$78.66
|
| Rate for Payer: UMR Bronson Commercial |
$109.94
|
|
|
CHG DX NTRAOP EPCAR CAR US CHD PLMT MNPJ&IMG ACQUISJ
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 76988
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$137.80 |
| Rate for Payer: Aetna Medicare |
$106.00
|
| Rate for Payer: BCBS Complete |
$40.26
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Meridian Medicaid |
$40.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.87
|
| Rate for Payer: Priority Health Narrow Network |
$91.87
|
| Rate for Payer: Priority Health SBD |
$91.87
|
| Rate for Payer: UHCCP Medicaid |
$38.34
|
| Rate for Payer: UMR Bronson Commercial |
$97.52
|
|
|
CHG ECHOENCEPHALOGRAPHY REAL TIME IMAGING
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 76506
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$1,651.99 |
| Rate for Payer: Aetna Commercial |
$132.51
|
| Rate for Payer: Aetna Medicare |
$102.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.40
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$98.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.99
|
| Rate for Payer: BCN Commercial |
$166.64
|
| Rate for Payer: BCN Medicare Advantage |
$98.89
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$132.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.83
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Nomi Health Commercial |
$118.67
|
| Rate for Payer: PACE SWMI |
$98.89
|
| Rate for Payer: PHP Commercial |
$138.45
|
| Rate for Payer: PHP Medicare Advantage |
$98.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.99
|
| Rate for Payer: Priority Health Medicare |
$98.89
|
| Rate for Payer: Priority Health Narrow Network |
$173.99
|
| Rate for Payer: Priority Health SBD |
$47.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.89
|
| Rate for Payer: UHC Medicare Advantage |
$98.89
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
| Rate for Payer: UMR Bronson Commercial |
$147.20
|
|
|
CHG ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 76825
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$402.91 |
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Aetna Commercial |
$310.10
|
| Rate for Payer: Aetna Medicare |
$240.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.24
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$231.42
|
| Rate for Payer: BCBS Trust/PPO |
$244.94
|
| Rate for Payer: BCN Commercial |
$384.59
|
| Rate for Payer: BCN Medicare Advantage |
$231.42
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$310.10
|
| Rate for Payer: Cofinity Commercial |
$333.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.99
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Nomi Health Commercial |
$277.70
|
| Rate for Payer: PACE SWMI |
$231.42
|
| Rate for Payer: PHP Commercial |
$323.99
|
| Rate for Payer: PHP Medicare Advantage |
$231.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.91
|
| Rate for Payer: Priority Health Medicare |
$231.42
|
| Rate for Payer: Priority Health Narrow Network |
$402.91
|
| Rate for Payer: Priority Health SBD |
$120.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.42
|
| Rate for Payer: UHC Medicare Advantage |
$231.42
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
| Rate for Payer: UMR Bronson Commercial |
$127.88
|
|
|
CHG ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 76826
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$273.66 |
| Rate for Payer: Aetna Commercial |
$185.68
|
| Rate for Payer: Aetna Medicare |
$144.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.54
|
| Rate for Payer: BCBS Complete |
$25.95
|
| Rate for Payer: BCBS MAPPO |
$138.57
|
| Rate for Payer: BCBS Trust/PPO |
$273.66
|
| Rate for Payer: BCN Commercial |
$230.17
|
| Rate for Payer: BCN Medicare Advantage |
$138.57
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$185.68
|
| Rate for Payer: Cofinity Commercial |
$199.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.50
|
| Rate for Payer: Meridian Medicaid |
$25.95
|
| Rate for Payer: Nomi Health Commercial |
$166.28
|
| Rate for Payer: PACE SWMI |
$138.57
|
| Rate for Payer: PHP Commercial |
$194.00
|
| Rate for Payer: PHP Medicare Advantage |
$138.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.23
|
| Rate for Payer: Priority Health Medicare |
$138.57
|
| Rate for Payer: Priority Health Narrow Network |
$241.23
|
| Rate for Payer: Priority Health SBD |
$59.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.57
|
| Rate for Payer: UHC Medicare Advantage |
$138.57
|
| Rate for Payer: UHCCP Medicaid |
$24.71
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG ENDOVASC REPAIR AAA
|
Professional
|
Both
|
$512.00
|
|
|
Service Code
|
HCPCS 75952
|
| Min. Negotiated Rate |
$204.80 |
| Max. Negotiated Rate |
$332.80 |
| Rate for Payer: Aetna Medicare |
$256.00
|
| Rate for Payer: BCBS Complete |
$204.80
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.80
|
| Rate for Payer: UMR Bronson Commercial |
$235.52
|
|
|
CHG EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 75957
|
| Min. Negotiated Rate |
$178.71 |
| Max. Negotiated Rate |
$629.42 |
| Rate for Payer: Aetna Commercial |
$345.53
|
| Rate for Payer: Aetna Medicare |
$296.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.53
|
| Rate for Payer: BCBS Complete |
$187.65
|
| Rate for Payer: BCBS Trust/PPO |
$399.39
|
| Rate for Payer: BCN Commercial |
$629.42
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Meridian Medicaid |
$187.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.15
|
| Rate for Payer: Priority Health Narrow Network |
$431.15
|
| Rate for Payer: Priority Health SBD |
$431.15
|
| Rate for Payer: UHCCP Medicaid |
$178.71
|
| Rate for Payer: UMR Bronson Commercial |
$272.78
|
|
|
CHG EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 75956
|
| Min. Negotiated Rate |
$208.53 |
| Max. Negotiated Rate |
$691.96 |
| Rate for Payer: Aetna Commercial |
$403.09
|
| Rate for Payer: Aetna Medicare |
$346.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.09
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS Trust/PPO |
$514.56
|
| Rate for Payer: BCN Commercial |
$691.96
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$501.97
|
| Rate for Payer: Priority Health Narrow Network |
$501.97
|
| Rate for Payer: Priority Health SBD |
$501.97
|
| Rate for Payer: UHCCP Medicaid |
$208.53
|
| Rate for Payer: UMR Bronson Commercial |
$318.78
|
|
|
CHG FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 76818
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$250.41 |
| Rate for Payer: Aetna Commercial |
$145.19
|
| Rate for Payer: Aetna Medicare |
$112.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.02
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$108.35
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: BCN Medicare Advantage |
$108.35
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$145.19
|
| Rate for Payer: Cofinity Commercial |
$156.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.77
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Nomi Health Commercial |
$130.02
|
| Rate for Payer: PACE SWMI |
$108.35
|
| Rate for Payer: PHP Commercial |
$151.69
|
| Rate for Payer: PHP Medicare Advantage |
$108.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.72
|
| Rate for Payer: Priority Health Medicare |
$108.35
|
| Rate for Payer: Priority Health Narrow Network |
$182.72
|
| Rate for Payer: Priority Health SBD |
$75.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.35
|
| Rate for Payer: UHC Medicare Advantage |
$108.35
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UMR Bronson Commercial |
$154.10
|
|
|
CHG FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 76819
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$173.81 |
| Rate for Payer: Aetna Commercial |
$104.91
|
| Rate for Payer: Aetna Medicare |
$81.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.74
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$78.29
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$123.15
|
| Rate for Payer: BCN Medicare Advantage |
$78.29
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$104.91
|
| Rate for Payer: Cofinity Commercial |
$112.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.20
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$93.95
|
| Rate for Payer: PACE SWMI |
$78.29
|
| Rate for Payer: PHP Commercial |
$109.61
|
| Rate for Payer: PHP Medicare Advantage |
$78.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.91
|
| Rate for Payer: Priority Health Medicare |
$78.29
|
| Rate for Payer: Priority Health Narrow Network |
$131.91
|
| Rate for Payer: Priority Health SBD |
$55.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.29
|
| Rate for Payer: UHC Medicare Advantage |
$78.29
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
| Rate for Payer: UMR Bronson Commercial |
$105.80
|
|
|
CHG FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 77003
|
| Min. Negotiated Rate |
$17.89 |
| Max. Negotiated Rate |
$909.73 |
| Rate for Payer: Aetna Commercial |
$124.39
|
| Rate for Payer: Aetna Medicare |
$96.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.68
|
| Rate for Payer: BCBS Complete |
$18.78
|
| Rate for Payer: BCBS MAPPO |
$92.83
|
| Rate for Payer: BCBS Trust/PPO |
$909.73
|
| Rate for Payer: BCN Commercial |
$155.40
|
| Rate for Payer: BCN Medicare Advantage |
$92.83
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$124.39
|
| Rate for Payer: Cofinity Commercial |
$133.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.47
|
| Rate for Payer: Meridian Medicaid |
$18.78
|
| Rate for Payer: Nomi Health Commercial |
$111.40
|
| Rate for Payer: PACE SWMI |
$92.83
|
| Rate for Payer: PHP Commercial |
$129.96
|
| Rate for Payer: PHP Medicare Advantage |
$92.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.19
|
| Rate for Payer: Priority Health Medicare |
$92.83
|
| Rate for Payer: Priority Health Narrow Network |
$162.19
|
| Rate for Payer: Priority Health SBD |
$43.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.83
|
| Rate for Payer: UHC Medicare Advantage |
$92.83
|
| Rate for Payer: UHCCP Medicaid |
$17.89
|
| Rate for Payer: UMR Bronson Commercial |
$138.00
|
|
|
CHG FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 77001
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$151.92 |
| Rate for Payer: Aetna Commercial |
$116.94
|
| Rate for Payer: Aetna Commercial |
$116.94
|
| Rate for Payer: Aetna Medicare |
$90.76
|
| Rate for Payer: Aetna Medicare |
$90.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.67
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$87.27
|
| Rate for Payer: BCBS MAPPO |
$87.27
|
| Rate for Payer: BCBS Trust/PPO |
$101.43
|
| Rate for Payer: BCBS Trust/PPO |
$101.43
|
| Rate for Payer: BCN Commercial |
$147.58
|
| Rate for Payer: BCN Commercial |
$147.58
|
| Rate for Payer: BCN Medicare Advantage |
$87.27
|
| Rate for Payer: BCN Medicare Advantage |
$87.27
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Cofinity Commercial |
$125.67
|
| Rate for Payer: Cofinity Commercial |
$125.67
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.63
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Nomi Health Commercial |
$104.72
|
| Rate for Payer: Nomi Health Commercial |
$104.72
|
| Rate for Payer: PACE SWMI |
$87.27
|
| Rate for Payer: PACE SWMI |
$87.27
|
| Rate for Payer: PHP Commercial |
$122.18
|
| Rate for Payer: PHP Commercial |
$122.18
|
| Rate for Payer: PHP Medicare Advantage |
$87.27
|
| Rate for Payer: PHP Medicare Advantage |
$87.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.92
|
| Rate for Payer: Priority Health Medicare |
$87.27
|
| Rate for Payer: Priority Health Medicare |
$87.27
|
| Rate for Payer: Priority Health Narrow Network |
$151.92
|
| Rate for Payer: Priority Health Narrow Network |
$151.92
|
| Rate for Payer: Priority Health SBD |
$27.20
|
| Rate for Payer: Priority Health SBD |
$27.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.27
|
| Rate for Payer: UHC Medicare Advantage |
$87.27
|
| Rate for Payer: UHC Medicare Advantage |
$87.27
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UMR Bronson Commercial |
$78.66
|
| Rate for Payer: UMR Bronson Commercial |
$68.54
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
77002
|
| Min. Negotiated Rate |
$50.16 |
| Max. Negotiated Rate |
$102.60 |
| Rate for Payer: Aetna American Axle |
$74.10
|
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.10
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$79.80
|
| Rate for Payer: Cofinity Commercial |
$98.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Healthscope Commercial |
$102.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.90
|
| Rate for Payer: PHP Commercial |
$96.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health SBD |
$71.82
|
| Rate for Payer: UMR Bronson Commercial |
$50.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.50
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 77002
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,036.52 |
| Rate for Payer: Aetna Commercial |
$137.19
|
| Rate for Payer: Aetna Medicare |
$106.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.43
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$102.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,036.52
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: BCN Medicare Advantage |
$102.38
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$137.19
|
| Rate for Payer: Cofinity Commercial |
$147.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.50
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$122.86
|
| Rate for Payer: PACE SWMI |
$102.38
|
| Rate for Payer: PHP Commercial |
$143.33
|
| Rate for Payer: PHP Medicare Advantage |
$102.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.61
|
| Rate for Payer: Priority Health Medicare |
$102.38
|
| Rate for Payer: Priority Health Narrow Network |
$178.61
|
| Rate for Payer: Priority Health SBD |
$40.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.38
|
| Rate for Payer: UHC Medicare Advantage |
$102.38
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
77002
|
| Min. Negotiated Rate |
$42.18 |
| Max. Negotiated Rate |
$184.04 |
| Rate for Payer: Aetna American Axle |
$74.10
|
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.10
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS Trust/PPO |
$184.04
|
| Rate for Payer: BCN Commercial |
$184.04
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$79.80
|
| Rate for Payer: Cofinity Commercial |
$98.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Healthscope Commercial |
$102.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.90
|
| Rate for Payer: PHP Commercial |
$96.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health SBD |
$71.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.30
|
| Rate for Payer: UHC Exchange |
$105.73
|
| Rate for Payer: UMR Bronson Commercial |
$42.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.50
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 77002
|
| Hospital Charge Code |
77002
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,036.52 |
| Rate for Payer: Aetna Commercial |
$137.19
|
| Rate for Payer: Aetna Medicare |
$106.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.43
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$102.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,036.52
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: BCN Medicare Advantage |
$102.38
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$147.43
|
| Rate for Payer: Cofinity Commercial |
$137.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.50
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$122.86
|
| Rate for Payer: PACE SWMI |
$102.38
|
| Rate for Payer: PHP Commercial |
$143.33
|
| Rate for Payer: PHP Medicare Advantage |
$102.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.61
|
| Rate for Payer: Priority Health Medicare |
$102.38
|
| Rate for Payer: Priority Health Narrow Network |
$178.61
|
| Rate for Payer: Priority Health SBD |
$40.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.38
|
| Rate for Payer: UHC Medicare Advantage |
$102.38
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
CHG FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 76001
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$43.55 |
| Rate for Payer: Aetna Medicare |
$33.50
|
| Rate for Payer: BCBS Complete |
$26.80
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
|
|
CHG FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 76000
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$366.11 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare |
$40.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.48
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$39.22
|
| Rate for Payer: BCBS Trust/PPO |
$366.11
|
| Rate for Payer: BCN Commercial |
$63.53
|
| Rate for Payer: BCN Medicare Advantage |
$39.22
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$52.55
|
| Rate for Payer: Cofinity Commercial |
$56.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.18
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Nomi Health Commercial |
$47.06
|
| Rate for Payer: PACE SWMI |
$39.22
|
| Rate for Payer: PHP Commercial |
$54.91
|
| Rate for Payer: PHP Medicare Advantage |
$39.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.70
|
| Rate for Payer: Priority Health Medicare |
$39.22
|
| Rate for Payer: Priority Health Narrow Network |
$65.70
|
| Rate for Payer: Priority Health SBD |
$22.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.22
|
| Rate for Payer: UHC Medicare Advantage |
$39.22
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
|
|
CHG GASTROESOPHAGEAL REFLUX STUDY
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 78262
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$653.51 |
| Rate for Payer: Aetna Commercial |
$267.18
|
| Rate for Payer: Aetna Medicare |
$207.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.12
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$199.39
|
| Rate for Payer: BCBS Trust/PPO |
$653.51
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$199.39
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$267.18
|
| Rate for Payer: Cofinity Commercial |
$287.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.36
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Nomi Health Commercial |
$239.27
|
| Rate for Payer: PACE SWMI |
$199.39
|
| Rate for Payer: PHP Commercial |
$279.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.50
|
| Rate for Payer: Priority Health Medicare |
$199.39
|
| Rate for Payer: Priority Health Narrow Network |
$348.50
|
| Rate for Payer: Priority Health SBD |
$48.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.39
|
| Rate for Payer: UHC Medicare Advantage |
$199.39
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UMR Bronson Commercial |
$47.38
|
|
|
CHG GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 82962
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$1,864.90 |
| Rate for Payer: Aetna Commercial |
$4.40
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.72
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,864.90
|
| Rate for Payer: BCN Commercial |
$3.28
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$4.40
|
| Rate for Payer: Cofinity Commercial |
$4.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.44
|
| Rate for Payer: Nomi Health Commercial |
$3.94
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PHP Commercial |
$4.59
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$3.28
|
| Rate for Payer: Priority Health Narrow Network |
$3.33
|
| Rate for Payer: Priority Health SBD |
$3.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$3.28
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
CHG GLUCOSE BLOOD REAGENT STRIP
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82948
|
| Min. Negotiated Rate |
$3.78 |
| Max. Negotiated Rate |
$2,965.35 |
| Rate for Payer: Aetna Commercial |
$6.75
|
| Rate for Payer: Aetna Medicare |
$5.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.26
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$5.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,965.35
|
| Rate for Payer: BCN Commercial |
$3.78
|
| Rate for Payer: BCN Medicare Advantage |
$5.04
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$7.26
|
| Rate for Payer: Cofinity Commercial |
$6.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.29
|
| Rate for Payer: Nomi Health Commercial |
$6.05
|
| Rate for Payer: PACE SWMI |
$5.04
|
| Rate for Payer: PHP Commercial |
$7.06
|
| Rate for Payer: PHP Medicare Advantage |
$5.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.99
|
| Rate for Payer: Priority Health Medicare |
$5.04
|
| Rate for Payer: Priority Health Narrow Network |
$4.99
|
| Rate for Payer: Priority Health SBD |
$4.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.04
|
| Rate for Payer: UHC Medicare Advantage |
$5.04
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
